THIS NOTICE DESCRIBES HOW  MEDICAL INFORMATION ABOUT YOU MAY BE USED AND  DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

Protecting the privacy of information about your  health is a responsibility we take very seriously.  We are committed to the practices and procedures established by Hospice & Community Care  to protect the confidential nature of information about your health. 

USES AND DISCLOSURES OF INFORMATION ABOUT YOUR HEALTH  WITHOUT YOUR AUTHORIZATION

The following categories describe different ways that we may use and disclose information about your health without your written authorization. We are including some examples.  Although we have attempted to make this thorough, not every use of disclosure in a category can be listed.

TO PROVIDE TREATMENT
Your health information may be used to coordinate care by Hospice & Community Care team members and others involved in your care such as your physician, pharmacist, suppliers of medical equipment, and others involved in your medical care. Your health care information may be disclosed to  individuals involved in your care, such as family members and clergy whom you have designated.  We also contact our patients’ families about  support services and educational opportunities.     

TO OBTAIN PAYMENT
Hospice & Community Care may use your health information to collect payment for the care you receive from us. For example, we may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or Hospice. We also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for Hospice care.

TO CONDUCT HEALTH CARE OPERATIONS
In order to facilitate the function of Hospice and to provide quality care to all of the Hospice patients, we may use and disclose health care information for our own operations.  Health care operations include administrative activities, training programs in which students learn under supervision, and licensing reviews.

IN THE HOSPICE HOUSE FACILITY
In the Hospice House facility, Hospice & Community Care may disclose certain information about you including your name, your general health status, religious affiliation and room location. We may disclose this information in the Hospice House Directory to people who ask for you by name.  Please inform us if you do not want your information  to be included in the directory.   

WHEN LEGALLY REQUIRED  
When required to do so by any Federal, State or local law, Hospice will disclose your health information.

WHEN THERE ARE RISKS TO PUBLIC HEALTH
Hospice & Community Care may disclose your health information in order to report disease, injury, and vital events such as birth or death; to report adverse events or product defects; to notify exposure to a communicable disease.      

TO REPORT ABUSE, NEGLECT OR DOMESTIC VIOLENCE
If Hospice believes a patient is the victim of abuse, neglect or domestic violence, Hospice is allowed to notify government authorities.   Hospice will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

TO CONDUCT HEALTH OVERSIGHT ACTIVITIES
Hospice & Community Care may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.  Hospice, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits. 

IN CONNECTION WITH JUDICIAL AND ADMINISTRATIVE PROCEEDINGS 
If you are involved in a lawsuit or a dispute, Hospice & Community Care may disclose your health information in response to a court or administrative order.  We may also disclose this information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.  We will make reasonable efforts to either notify you about the request or to obtain an order protecting your health information. 

FOR LAW ENFORCEMENT PURPOSES 
Your health information may be disclosed to a law enforcement official in response to a court order, warrant, summons, subpoena, or similar process. We may also release information about your health to law enforcement for the purpose of identifying or locating a suspect, fugitive, material witness or missing person.                            

TO CORONERS AND MEDICAL EXAMINERS
Hospice & Community Care may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.              

TO FUNERAL DIRECTORS
Hospice & Community Care may disclose your health information to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements.  If necessary, Hospice may disclose your health information prior to and in reasonable anticipation of your death.

FOR ORGAN, EYE OR TISSUE DONATION
Hospice & Community Care may use or disclose your health information to organ procurement organizations whom you have designated.

FOR RESEARCH PURPOSES 
Under very select circumstances, we may use your health information for research.

IN THE EVENT OF A SERIOUS THREAT TO HEALTH OR SAFETY                  
Consistent with applicable law and ethical standards of conduct, Hospice & Community Care may disclose your health information if we, in good faith, believe that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

 FOR SPECIFIED GOVERNMENT FUNCTIONS
In certain circumstances the Federal regulations authorize Hospice & Community care to use or disclose your health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.

FOR WORKER’S COMPENSATION 
We may release your health information for worker’s compensation or similar programs.

USES AND DISCLOSURES OR  INFORMATION ABOUT YOUR HEALTH WITH YOUR AUTHORIZATION  
Other than what is stated previously, Hospice & Community Care will only disclose your health information with your written authorization.  You may revoke that authorization in writing at any time.

YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION  

You have the following rights which must be submitted in writing.  All requests must be made to: Privacy Officer

Hospice & Community Care
2275 India Hook Rd.
Rock Hill, SC 29732.

RIGHT TO REQUEST RESTRICTIONS
You may request restrictions and/or limitations on certain uses and disclosures of your health information.  However, Hospice & Community Care may not be able to meet your request.  

RIGHT TO RECEIVE CONFIDENTIAL COMMUNICATIONS
You have the right to request that Hospice & Community Care  communicate with you in a certain way.  For example, you may ask that Hospice only conducts communications pertaining to your health information with you privately, with no other family members present.  We will attempt to honor your reasonable requests for confidential communications. 

RIGHT TO INSPECT AND COPY YOUR HEALTH INFORMATION
You have the right to inspect your health information, including billing records.  If you request a copy of your health information,  Hospice may charge a reasonable fee for copying and assembling costs associated with your request. 

RIGHT TO AMEND HEALTH CARE INFORMATION
If you or your representative believes that your health information records are incorrect or incomplete, you may request that Hospice & Community Care amend the records. That request may be made as long as your record is maintained by Hospice. A request for an amendment must include a reason for the amendment.  The request may be denied if your health information records were not created by Hospice & Community Care, or if, in our opinion, the records containing your health information are accurate and complete.        

RIGHT TO ACCOUNTING OF DISCLOSURES
you or your representative have the right to request an accounting of disclosures of your health information made by Hospice & Community Care for any reason other than for treatment, payment or health operations.  This request should specify the time period for the accounting (not to start before April 14, 2003).  Requests may not be made for periods of time in excess of six years. We will provide the first accounting you request during any 12-month period without charge. Subsequent requests may be subject to a reasonable cost-based fee. 

RIGHT TO A PAPER COPY OF THIS NOTICE  
You or your representative have a right to obtain a  copy of this Notice at any time.

DUTIES OF HOSPICE & COMMUNITY CARE
Hospice is required by law to:

• Maintain the privacy of your health information

• Provide to you and your representative this Notice of our duties and privacy practices

• Abide by terms of this Notice, as subject to amendment from time to time. 

CHANGES TO THIS NOTICE
If we change this Notice, Hospice will provide a copy of the revised Notice to you or your appointed representative. 

TO FILE A COMPLAINT
You or your personal representative have the right to express complaints to Hospice & Community Care and to the Secretary of Health and Human Services if you or your representative believe that your privacy rights have been violated.  Any complaints to Hospice & Community Care should be made in writing to the Privacy Officer.  We encourage you to express any concerns you may have regarding the privacy of your information. 

CONTACT & EFFECTIVE DATE
All issues regarding patient privacy and your rights under the Federal privacy standards should be directed to:

Jennifer Graham
Hospice & Community Care
2275 India Hook Rd.
Rock Hill, SC 29732
Phone 803-329-1500